Living with the symptoms

Key facts

MS can cause a wide variety of symptoms, but most people only experience a small number of these
Symptoms can come and go
Some symptoms are very responsive to treatment; others are more difficult to manage
No two people with MS experience the same symptoms to the same degree

Some symptoms, such as pain and fatigue, can worsen temporarily, for example during hot weather, whilst exercising, or if you have an infection. Sometimes it can be difficult to distinguish transient symptoms such as these from the onset of a relapse.

It is also important to remember that not all the symptoms you experience will necessarily be connected to your MS. You are still susceptible to all the ailments experienced by the general population.

Some of the more common symptoms are listed overleaf, with an indication of how they can be treated or managed. If you are experiencing these symptoms and they are causing you problems, ask your GP for help or to refer you to the appropriate specialist. There is no need to put up with them - don't suffer in silence!

Visual disturbances

Optic neuritis, or inflammation of the optic nerve, is often the first symptom of MS. Eye problems can include temporary loss of vision, double vision, pain and reduction in colour vision. Steroids can help to keep these symptoms under control.

Fatigue

An overwhelming sense of exhaustion and weariness is a very common symptom of MS. It can be particularly difficult to cope with since it is effectively an 'invisible' symptom that will not be obvious to other people. You may need to explain that fatigue is a specific symptom of MS and that you are not being lazy! There is a lot you can do to minimise the effects of fatigue, for example, by using time management and energy conservation techniques, by pacing yourself and by alternating periods of activity with rest. An occupational therapist can advise on the best ways to manage fatigue. For some people drug therapy can also be used to tackle the problem.

Bladder and bowel problems

Bladder problems include needing to empty the bladder more frequently and more urgently than usual. The most common bowel problem is constipation. Although these symptoms can be distressing and embarrassing, remember that they are usually very responsive to treatment. Ask your doctor to refer you for specialist continence advice.

Pain

For some time pain was not recognised as a symptom of MS, but more recently it has been acknowledged that there are two types of pain that can occur in MS. Pain may be neuropathic, ie caused directly by damage to the nerves. It is associated with stabbing pains, extreme skin sensitivity and burning sensations. The second type of pain, known as musculoskeletal pain, is not caused directly by MS but can develop through altered posture and positioning and is triggered by damage to tendons, ligaments, muscles or bones. In order to treat pain effectively, it is important to identify the cause. For example, nerve pain may be best managed using drugs, whilst musculoskeletal pain is best treated by a physiotherapist and/or occupational therapist.

Spasm

Nerve damage can cause muscles to contract into tight, often painful spasm. This symptom is not only distressing, but if it is not treated effectively, the functioning of the muscles can be affected. Therapists and doctors both play an important role in the management of spasm and may recommend a combination of exercise and drug therapy.

Mobility problems

Difficulties with walking can be caused by balance or coordination problems, dizziness or vertigo, muscle stiffness (spasticity) or weakness. A multidisciplinary team should manage this aspect of MS and input from a physiotherapist is very important.